Dr. Victor Bray is the Interim Director of the Pennsylvania Ear Institute of Salus University, as well as Dean of Salus University’s Osborne College of Audiology. Dr. Bray’s family has owned and operated hearing health care offices for three generations, which ultimately sparked his interest in the audiology field at a young age.
My family has owned and operated hearing health care offices in Georgia and Alabama for three generations[1]. After completing my undergraduate degree at the University of Georgia, I worked for my family business and found I enjoyed the diagnostic problem solving around hearing loss and the rehabilitative solution of hearing aids coupled with auditory training. After deciding that I wanted a career in this field, my father (who was not an audiologist), steered me towards getting a graduate degree in audiology because that would be the future of hearing health care. The Auburn University campus is near our home in Columbus, we have a satellite office in the Auburn sister-city of Opelika, and I worked my way through graduate school at Auburn University by going to classes full time while running that branch office 20 hours a week. I received my Doctor of Audiology degree at the University of Texas at Austin.
While completing my research degree in Austin Texas, I worked clinically as the Director of Audiology at the Austin Ear Clinic. This was in the early days of cochlear implants. The Nucleus device from Cochlear Corporation was just being approved for both adults and children, and we were also an FDA investigational site for an alternate cochlear implant, the Inneraid project. One patient., a seven year old girl with severe-to-profound hearing loss, was not getting adequate benefit from her hearing aids and was falling behind in school. She was at definite risk of academic failure to be followed by economic failure. She was one of the first cochlear-implant children in our clinic. I still have in my office the gift of sea shells she gave me, simulating the shapes of the ear and the cochlear implant. The gift, glued to blue construction paper, had the message “Thanks for hearing me out.” Following the cochlear implant procedure and associated rehabilitation, her home, family, school, and personal life improved significantly.
As Director of PEI, the most challenging aspect is insuring that we have a community-based hearing and balance center that runs on the best practices in audiology diagnostics and rehabilitation. As a public clinical facility, we have a responsibility to the community to provide holistic patient care, in the tradition of the Salus way. Also, Salus University Osborne College of Audiology, which runs PEI, is the largest Doctor of Audiology (AuD) training program in the country and PEI is the initial clinical training site for our future Doctors of Audiology. Insuring that we have the best faculty, the best staff, the best facilities, provide the best patient care, and provide the best student education is very challenging, and very rewarding to see happening.
The greatest challenge to our profession is ‘what will be the future of audiology?’ The profession made the decision in the late 20th century to transition from a master’s degree profession to a doctoral degree profession. The purpose of this additional training was so that audiologists could practice their profession autonomously and as point-of-entry for hearing healthcare patients. Now in the 21st century, as Salus University, the Osborne College of Audiology, and the Pennsylvania Ear Institute are training students and graduates to fulfill this higher role in our public health system, we are being held back from being a universal point-of-entry by the failure of Medicare to recognize the transition to our profession. The greatest challenge will be for our graduates to gain passage of the Audiology Patient Choice Act (HR 2519) so that our patients can directly seek, obtain, and be reimbursed for the diagnostic and rehabilitative care provided by our audiologists.
My professional fascination is hearing aids, amplification technologies, and the power of digital signal processing (DSP). In the early 1990’s, with the technology breakthroughs associated with multi-channel wideband compression, I saw firsthand how quality of life could dramatically be improved for patients through new hearing aid technology. I left clinical care and went to work in the hearing aid industry. I was able to work at two great American start-up companies (ReSound and Sonic Innovations) and as part of industry research and development (R&D), I was able to work at the cutting-edge of amplification technologies and bring new and wonderful products into the marketplace. Today’s DSP hearing aids can automatically eliminate feedback, change microphone settings to enhance environmental listening, have no occlusion effect in the ear canal, and are now ‘hearables’ that can communicate via Bluetooth with smart phones! Absolutely amazing technology! I still get a small thrill when I am talking with a person who is successfully wearing hearing aids, especially when I see that the aids are ones that I helped develop.
I have been at Salus University since 2009. It has been extremely rewarding to see a program that was struggling become one of the regional, national, and international leaders in audiology education. We have been able to recruit and retain talented faculty who provide outstanding education, both on campus and online. With this great faculty, we attract excellent students and produce incredible graduates. We also benefit from strong institutional administrative support and from having one of the most outstanding on-campus training facilities of any AuD program in the world. This job and the capability to work with such wonderful students, staff, and faculty is its own reward.
My outside interests mostly involve time at my home in Elkins Park. When I moved here, the house I bought was over 100 years old and in need of significant care. We completely rehabilitated the structure, turning it into an Arts & Crafts bungalow-style showpiece. As I continue to improve the interior, most of my efforts have now turned to the outdoors, where the large yard has been remade into a beautiful and charming landscape. My gardening philosophy is simple (and it is similar to my management style) – every plant has a place where it can excel, grow, and be beautiful. It is just the gardener’s job to find the right place and set up the right conditions for this to happen.
While I am now retired from direct patient care and do not see patients at PEI, what I like the most is having the administrative responsibility to shape the future of PEI, patient care services, and audiology education. Since 2009, we have expanded PEI two times, we have doubled the size of our clinical faculty, we have doubled the number of patients we see, and we have doubled the number of students we train. The faculty have developed or are in the process of developing many specialty services, including Auditory Processing evaluations, Cochlear Implant care, Falls Risk assessment, Tinnitus and Hyperacusis management, Vestibular Rehabilitation care, and of course, a concentration on state-of-the art Amplification Technologies (modern hearing aids and hearables) which can be coupled to high-technology Assistive Listening Devices (ALDs).
Patients need to know that their audiologists can do far more in diagnostics and rehabilitation than is currently recognized by Medicare. Patients need to talk to their audiologists about the Audiology Patient Choice Act, about how this will improve their access to much-needed audiology services for Medicare patients, and how it will allow audiologists to perform their full scope-of-practice for Medicare patients. Patients should then contact their representatives in Washington DC to urge support for the Audiology Patient Choice Act (HR 2519) so that patients can benefit from getting the most (not the least) from their audiologist and Medicare.
If you suspect you or someone you know has a hearing problem, please contact the Pennsylvania Ear Institute of Salus University at 215.780.3180 to schedule an appointment with a Doctor of Audiology.